The fact is most doctors have about 2 hours of formal nutrition training in medical school – and most of my colleagues cut class or slept through those lectures. Throughout my internship, residency and fellowship, I have had to self teach myself everything that I know about exercise and proper nutrition. I still have many unanswered questions. Should I run up or down the Ravenel Bridge? Are calories the only thing that matter? Should I graze or eat big? Are grits really good for me? Are synthetic sugars safe? What is a safe amount of alcohol consumption? Should bacon be banned? Is running or walking better? Over the next several months, I will tackle these topics and more in this column.

That brings me to our first big question: Does the place where we live and work make a difference in our overall health?

Without any hesitation, I say yes!

During my internship and residency in NYC, I found that no matter what I did, I was not optimizing a healthy lifestyle as it is impossible there. The daily threat of getting hit by a car, molested on a subway platform and breathing toxic fumes cannot be denied. After years of the high stress living, returning to Charleston made perfect sense. Charleston is absolutely conducive to healthy living. The only proof one needs is to step outside and look around or check out the photography page at the Charleston Daily. The pristine marshes, majestic sunsets, and serene beaches combined with manageable traffic patterns, relatively low noise pollution and really polite neighbors, make for a backdrop of relaxation. The stress of the day will melt away, if we let it. So rest assured, just by living in Charleston, you are making a healthy choice compared to living elsewhere.

This column will feature my (sometimes unorthodox) thoughts about how we as Charlestonians, or even as temporary guests, can make healthy living choices while maximizing all of the beauty the Holy City has to offer. Questions, suggestions and comments are very welcome. Until then, be well, Charleston! ~Dr. Jay

The doctor is in and this time I’ll try to answer the eternal health conundrum: are grits really good for you?

Coming from a hash-brown father and a polenta mother, grits were infrequently on our Missouri table. After moving to South Carolina, I tried my first taste of properly prepared grits at the late Anson Street Café. Those bites changed my world. The creamy, buttery warmth made me suddenly happy. There is solid medical evidence that happiness improves one’s sense of well-being and mental health. Logic follows that grits are, at least somewhat, good for you.

However, the nutritional content of grits is relatively dismal. I will spare you the details of the individual packets of cheese- or butter-flavored instant grits. Don’t eat those. Ever. The word “instant” means place directly in a trash can.

The two other types of grits found in grocery stores are quick grits and slow-cook grits. They are both available in canisters in the cereal aisle. Among the slow-cook grits are packages of stone-ground and heirloom varieties from purveyors such as Anson Mills and Adluh. These products have larger grit size, and for reasons I explain below, are healthier than fine grain quick or slow-cook grits.

If you are familiar with the movie My Cousin Vinny, you know that, simply put, grits are corn. Corn is mostly carbohydrates. Carbohydrates are sugar. And sugar is bad, right? We are raised to believe sugar rots the teeth, causes obesity and contributes to diabetes. All true. However, carbohydrates are a ready source of energy for the brain. They can be used immediately by neurons and keep the brain mentally sharp unlike the slow release of energy that occurs while in ketosis, i.e. in a state of starvation or while on a low carbohydrate diet. What I am saying is, my patients are in better hands when I have grits for breakfast as opposed to a hard-boiled egg and sausage. Thus, grits are good for the mind.

Finally, while calories matter, a phenomenon known as the Glycemic Index is important as well. I have personally read and referred my patients to read the Glycemic Load Diet, by Cardiologist Dr. Rob Thompson. This diet plan has yielded great results in weight loss and diabetes management for many of my patients. The rationale is that the quicker carbohydrates are broken down from food into glucose, the faster and higher the resultant insulin spike is produced by the pancreas. High and fast insulin spikes leads to insulin resistance, heralding obesity and diabetes. The numerical value measuring the rate at which glucose is released from a food is called the Glycemic Index (GI). The higher the GI, the faster the blood glucose and insulin spike. The GI of pure sugar is 100. White bread is 99. Instant oatmeal is 83. Lettuce is 10. Any food above 69 is considered to have a high GI and should be avoided. Grits prepared with water has a GI of 69.

Fortunately, it is known that the less food is processed and cooked, the lower the GI it retains. Thus the larger the grit size, the lower the GI making course, stone-ground grits preferable. Likewise, cooking foods with fat (i.e. butter and milk) lowers the GI as well. Finally, yellow corn is slighter lower in calories than white corn and thus preferred where health is concerned.

It follows that yellow, stone-ground, slow-cook (less-processed) grits cooked with butter and milk have a lower GI than instant grits prepared with water making these more delicious grits relatively healthier. Make no mistake, they are loaded with calories (up to 300 calories per cup), but they have a moderate GI and they make us happy. That combination is good. Thus, grits are good for you.

So help yourself to a modest helping at your next brunch and until we meet again, be well Charleston.